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Lung Diffusion Capacity and Efficiency of Pulmonary Gas Exchange in Chronic Thromboembolic Pulmonary Hypertension

https://doi.org/10.18087/cardio.2018.7.10144

Abstract

Aim: to study lung diffusion capacity and efficiency of pulmonary ventilation in patients with chronic thromboembolic pulmonary hypertension (CTEPH) depending on the severity of pulmonary hypertension. Materials and Methods. The study included 139 patients with CTEPH. The parameters of body plethysmography, lung diffusion capacity, efficiency of pulmonary ventilation and their interrelation with results of angiopulmonography were assessed. Results. Patients were divided according to systolic pulmonary artery pressure (SPAP): group 1 - < 50, group 2 - 50-80, group 3 - > 80 mm Hg. The lung diffusion capacity and the efficiency of pulmonary ventilation in patients with CTEPH were reduced against the background of normal spirometric parameters, most pronouncedly in group 3. Regression analysis revealed an inverse relationship between severity of pulmonary hypertension and lung diffusion capacity (regression coefficient -13.7 [-19.1; -8.3], p<0.001), pulmonary ventilation efficiency (regression coefficient -1.4 [-3.5; -0.1], p=0.046), and arterial oxygenation (regression coefficient -1.3 [-2.0; -0.7], p=0.001). Conclusion. In patients with CTEPH against a background of normal basic spirometric parameters, the lung diffusion capacity and efficiency of pulmonary ventilation were significantly decreased, most pronouncedly at SPAP > 80 mm Hg. The results of the study demonstrate the close relationship between pulmonary hypertension and respiratory ventilation-diffusion disorders in patients with CTEPH.

About the Authors

O. V. Kamenskaya
National Medical Research Center named after acad. E. N. Meshalkina
Russian Federation


Irina Yu. Loginova
National Medical Research Center named after acad. E. N. Meshalkina
Russian Federation


A. M. Chernyavskiy
National Medical Research Center named after acad. E. N. Meshalkina
Russian Federation


D. V. Khabarov
Scientific Institute of Clinical and Experimental Lymрhology
Russian Federation


V. V. Lomivorotov
National Medical Research Center named after acad. E. N. Meshalkina
Russian Federation


References

1. Lang I. M., Pesavento R., Bonderman D., Yuan J. X. Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: a current understanding. Eur Respir J. 2013;41:462-468. DOI: 10.1183/09031936.00049312

2. Delcroix M., Lang I., Pepke-Zaba J. et al. Long-term outcome of patients with chronic thromboembolic pulmonary hypertension. Clinical Perspective. Circulation 2016;133 (9):859-871. DOI: 10.1161 /circulationaha. 115.016522

3. McGoon M. D., Benza R. L., Escribano-Subias P. et al. Pulmonary arterial hypertension. J. Am Coll Cardiol 2013;62 (25):D51-D59. DOI: 10.1016/j. jacc. 2013.10.023

4. Giuliani L., Piccinino C., DArmini M. A. et al. Prevalence of undiagnosed chronic thromboembolic pulmonary hypertension after pulmonary embolism. Blood Coagulation & Fibrinolysis 2014;25 (7):649-53. DOI: 10.1097/mbc. 0000000000000084

5. Гуревич М. А. Тромбоэмболия легочной артерии (вопросы клиники, диагностики и терапии). Альманах клинической медицины 2015;38:90-94.

6. Савельев В. С., Чазов Е. И., Гусев Е. И. и др. Российские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. Флебология 2010;4 (2-1):2-37.

7. Hoeper M. M., Meyer K., Rademacher J. et al. Diffusion capacity and mortality in patients with pulmonary hypertension due to heart failure with preserved ejection fraction. JACC: Heart Failure 2016;4 (6):441-449. DOI: 10.1016/j. jchf. 2015.12.016

8. Steenhuis L. H., Groen H.J. M., Koëter G. H., van der Mark T. H. W. Diffusion capacity and haemodynamics in primary and chronic thromboembolic pulmonary hypertension. Eur Respir J. 2000;16 (2):276-281. DOI: 10.1034/j. 1399-3003.2000.16b15.x

9. Каменская О. В., Клинкова А. С., Ломиворотов В. В. и др. Риск развития осложнений при коронарном шунтировании с учетом эффективности легочно вентиляции. Патология кровообращения и кардиохирургия 2015;19 (3):68-73.) DOI: 10.21688/1681-3472-2015-3-68-73

10. Miller M. R., Crapo R., Hankinson J. et al. General considerations for lung function testing. Eur Respir J. 2005;26:153-161. DOI: 10.1183/09031936.05.00034505

11. Pellegrino R., Viegi G., Brusasco V. et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26 (5):948-968. DOI: 10.1183/09031936.05.00035205

12. Баздырев Е. Д., Поликутина О. М., Каличенко Н. А. и др. Комплексная оценка респираторного статуса пациентов с ишемической болезнью сердца перед проведением планового коронарного шунтирования. Пульмонология 2015;25 (6):704-712.

13. Neas L. M., Schwartz J. Pulmonary function levels as predictors of mortality in a national sample of US adults. American J. Epidemiology 1998;147 (11):1011-1018. DOI: 10.1093/oxfordjournals. aje. a009394

14. Chapman H. A. Epithelial-mesenchymal interactions in pulmonary fibrosis. Annual Review of Physiology 2011;73 (1):413-435. DOI: 10.1146/ annurev-physiol-012110-142225

15. Савушкина О. И., Черняк А. В. Клиническое применение метода бодиплетизмографии. Атмосфера. Пульмонология и аллергология 2013;2:38-41.

16. Каменская О. В., Клинкова А. С., Чернявский А. М. и др. Эффективность легочной вентиляции в отдаленные сроки после операции у больных хронической тромбоэмболией легочной артерии. Кардиология 2015;55 (9):16-21.) DOI: 10.18565/cardio. 2015.9.16-21

17. Iversen K. K., Kjaergaard J., Akkan D. et al. The prognostic importance of lung function in patients admitted with heart failure. Eur J. Heart Fail 2010;12 (7):685-691. DOI: 10.1093/eurjhf/hfq050


Review

For citations:


Kamenskaya O.V., Loginova I.Yu., Chernyavskiy A.M., Khabarov D.V., Lomivorotov V.V. Lung Diffusion Capacity and Efficiency of Pulmonary Gas Exchange in Chronic Thromboembolic Pulmonary Hypertension. Kardiologiia. 2018;58(7):53-58. (In Russ.) https://doi.org/10.18087/cardio.2018.7.10144

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ISSN 0022-9040 (Print)
ISSN 2412-5660 (Online)